Individual provider Active NPI

Mykale R Elbe, FNP

  • Family Nurse Practitioner
  • Mascoutah, IL
National Provider Identifier
1356697726
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012026932 Issued in MO
Practice address
124 W Main St
Mascoutah, IL 62258-2039
Phone
(618) 792-8537
Fax
(618) 389-6337
NPI assigned
Aug 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2008022802 MO
Family Nurse Practitioner 363LF0000X 2012026932 MO Primary

Addresses

Primary practice location

124 W Main St
Mascoutah, IL 62258-2039

Mailing address

124 W Main St
Mascoutah, IL 62258-2039
Phone (618) 792-8537

Other names 1

  • Mrs. Mykale R Hogan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121126000454 MO Practitioner - Nurse Practitioner 7517118417 Reassigns benefits to 2 organizations
I20241106001838 IL Practitioner - Nurse Practitioner 7517118417 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008022802MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Practice Nursing Services Inc CurrentSince Dec 28, 2024 Accepting new patients
Mercy Clinic East Communities CurrentSince Apr 23, 2018 Accepting new patients
Mercy Hospitals East Communities CurrentSince Oct 23, 2017 Accepting new patients
Mercy Hospitals East Communities CurrentSince Oct 23, 2017 Accepting new patients

Locations

746 Urbanna Dr
Freeburg, IL 62243
Phone (618) 317-1537

124 W Main St
Mascoutah, IL 62258
Phone (618) 402-5572

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1356697726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W MAIN ST",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622582039",
            "telephone_number": "618-792-8537",
            "fax_number": "618-389-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W MAIN ST",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622582039",
            "telephone_number": "618-792-8537",
            "fax_number": "618-389-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBE",
        "first_name": "MYKALE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2008022802",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012026932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYKALE",
            "last_name": "HOGAN",
            "middle_name": "R",
            "prefix": "MRS.",
            "credential": "DNP, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mascoutah, IL

Sources for this page

Verify at the official NPI Registry.